Insurance; CUIPA; General Statutes § 38a-816 (10); Discrimination; Whether
Trial Court Properly Found that Insurer did not Violate CUIPA by Reimbursing
Podiatrists at Lower Rates than Medical Doctors for Same Medical Services. The
named plaintiff and three doctors of podiatric medicine, who are network
providers of podiatric services under a contract with the defendant insurer, filed
a class action against the defendant, alleging a violation of the Connecticut
Unfair Insurance Practices Act (CUIPA). The plaintiffs alleged that the
defendant reimbursed podiatrists at lower rates than medical doctors for the
same foot-related health care services. They claimed that this practice
constituted unfair discrimination in violation of General Statutes § 38a-816
(10) of CUIPA, which provides in part: "[W]henever [any] insurance policy
or certificate or service contract provides for reimbursement for any services
which may be legally performed by any practitioner of the healing arts licensed
to practice in this state, reimbursement . . . shall not be denied because of
race, color or creed nor shall any insurer make or permit any unfair
discrimination against particular individuals or persons so licensed." The
defendant filed a motion for summary judgment, which the trial court granted. In
reaching its decision, the court found that the meaning of § 38a-816 (10) was
ambiguous. Consulting the legislative history of the statute, the court found that
the legislature intended to protect patients by allowing them to be treated by
the "practitioner of the healing arts" of their choice and to have
the cost of such treatment covered under health insurance policies. The court also
found that the purpose of the statute was to protect these practitioners by
requiring insurance companies to reimburse them for patient care, not to mandate
payment parity among the classes of practitioners. It concluded, consequently,
that the defendant's acts in not reimbursing the plaintiffs and medical doctors
the same amounts for the same treatments did not constitute "unfair
discrimination" in violation of CUIPA. The plaintiffs appeal, challenging
the trial court's interpretation of § 38a-816 (10). The defendant claims, as
an alternate ground to affirm the trial court's judgment, that the individual
plaintiffs' alleged harm was too remote to provide them with standing to sue
for damages because the reimbursement amounts were not paid to any of the
plaintiffs directly, but, rather, to their podiatry practice groups.